DOH Distributes MLTC Quality Initiative Methodology

The Department of Health (DOH) has released the 2017 Managed Long Term Care (MLTC) Quality Incentive methodology listing the measures that comprise four domains. The Quality Measure domain is comprised of ten measures, most of which are risk-adjusted, each worth a possible 5 points. The measures will be computed using January through June 2017 Universal Assessment System for New York (UAS-NY) data and 2017 satisfaction survey results. The Satisfaction Measure domain includes six risk-adjusted satisfaction measures each worth a maximum of 5 points and will be based on 2017 satisfaction survey results. The survey is expected to be mailed in February 2017, with results released in early 2018. Six reporting measures each worth 2 points comprise the compliance measures domain. These will be based on 2016 reporting, or January through June 2017 UAS-NY data. The final domain is a measure of potentially avoidable hospitalizations and is worth a maximum of 10 points. It is based on inpatient hospitalizations related to one of six primary diagnoses that might have been avoided if proper outpatient care had been received in a timely manner.

DOH intends to calculate the quality measures in late fall of 2017 and share the results with plans for feedback prior to publication. The payment for the 2017 quality incentive will be calculated as a rate adjustment to SFY 2017-18 rates and is expected to be made as a lump sum payment in the summer of 2018. The methodology document is available here, and the question and answer document is here.